Section 3
1)Accident Reporting and Investigation
a)Introduction
When an accident occurs, it often appears that its cause was someone failing to follow prescribed procedures. The injured person is perceived as either being “careless” or not paying attention to the task at hand. Corrective measures include admonitions to “be more careful” or “get help.”
In truth, there are many reasons why accidents occur. The purpose of investigating accidents is to identify the root cause(s) of the accident, to identify exactly why it happened, so that we can develop effective measures to reduce or eliminate the possibility of recurrence.
In this manual section, you will find guidelines and procedures for investigating accidents, as well as a report form for reporting the results of your investigation. The most important thing to remember is that you are looking for facts, not fault.
b)Policy
An individual should be assigned the responsibility for coordinating accident investigations at the institution. This includes incidents and accidents that injure individuals on campus, those that result in property damage and “near misses.”
c)Accident Reporting and Investigation
i)Introduction
When an accident occurs, people may be injured and property may be damaged. In order to treat the injuries promptly and prevent further damage, it is essential for the occurrence to be reported as soon as possible. This manual section describes the procedures for reporting and investigating an accident.
ii)Management Responsibilities
–Department heads have designated first level responders, who have current first aid certification and know when to call for higher-level emergency medical treatment.
–Department heads have communicated to all their employees a reporting chain, from the first level of management up through to the department head and Administration.
–Department heads will review all emergency response procedures with their staffs at least annually. These procedures cover both natural disasters (tornado, hurricane, earthquake) and man-made events (hostages, civil strife, bomb threat).
–The institution’s designated representative will notify the injured person’s next of kin as appropriate.
–If the injury requires hospitalization, the institution will make arrangements to have the spouse or other family member transported to the hospital, to reduce the possibility of an excited family member being involved in an accident while driving to the hospital.
iii)Accident Reporting
–Any witness to an incident in which there is a personal injury or property damage should notify his/her immediate supervisor as soon as possible by the best available means.
–If the injury appears to be life-threatening or there is a possibility of significant additional damage, notify Campus Security or 911.
–Offer assistance and comfort to the best of your ability and take such actions as you can to prevent additional injuries.
–Note details of the event for later reporting.
–The department head should notify Administration, including the Risk Manager and Campus Safety Director, of all injuries involving a student, staff, faculty member or a member of the public.
–The risk manager will notify the affected insurance companies within 24 hours, even if all the information on the incident is not available. (See current mandatory reporting requirements on the claim reporting card (Sample in manual))
–The campus safety manager will notify a regulatory body (such as OSHA) if appropriate, after conferring with Administration.
–If a statement is to be made to the press, the designated institutional representative should first confer with Administration.
iv)Accident Investigation
It is essential that all significant accidents be investigated. There are several reasons for this:
–Identify the cause(s) so that appropriate changes can be made to prevent future occurrences.
–Prepare a legal defense as necessary.
–Demonstrate administration’s commitment to maintaining a safe campus environment.
v)Procedures
–The supervisor of the person injured (or the driver of the institution vehicle involved in the accident) will complete the accident investigation report.
–Begin the investigation as soon as possible. Ensure that the injured person has gotten any necessary medical treatment.
–When notified of the accident, “freeze” the site as much as possible. “Freezing a site” means that nothing is disturbed; everything is left just as it was at the time of the accident
–When you get to the site, get the “big picture” first. Take pictures or make diagrams as appropriate.
–Separate the injured person and any witnesses to keep their stories from contaminating each other. Talk with the injured person at the scene if possible.
–Interview each witness separately and privately. Try to put each one at ease. The purpose of the investigation is to find facts, not assign blame.
–Ask open-ended “W” questions: Who, what, when, where, why and how. Try to develop facts, not opinions.
–Ask for suggestions on how to prevent future accidents of this type. Develop your conclusions and then start your report (refer to the sample report form at Appendix 3-A).
–Enter the personal data of the injured person as applicable. Describe the extent of injuries or property damage as you understand it to be at this time.
–List the hospital/clinic and treating doctor so that they can be contacted for further information. If the injured employee has been cleared to return to work (RTW), indicate this fact in the space provided.
–Describe what happened. (Example— “Employee struck by truck in driveway.” Based on your investigation, in a logical sequence of events describe how the accident occurred.) Describe what the employee was doing just prior to the accident. Identify specific corrective measures that should be implemented to prevent recurrence.
–Keep a copy of the completed accident investigation form for review by interested third parties (EIIA, insurance carriers, governmental agencies, et al).
Casualty Risk Control Manual
Risk Management Administration Programs
Appendix 3-A
Non Vehicle Accident Investigation Report Form
Name: / Department:Job Title: / ID Number/SSAN
M / F / Age: / Date of Hire: / Home Phone No.:
Address:
Extent of Injuries:
Describe any Property Damage:
Treatment Facility: / Treating Doctor:
RTW Status:
Where is the damaged property now?
Time of Incident: / Time Supervisor Notified:
What Happened?
How did it happen?
What was the employee doing just prior to the incident?
What management controls were deficient?
Equipment: / Selection / Arrangement / Use / Maintenance
Materials: / Selection / Placement/Storage / Handling / Use
People: / Selection / Placement / Training / Leading
What specific measures should be taken?
How will this improve operations?
What have you already done?
Investigated by: / Date:
Reviewed by: / Date:
Add any additional details necessary to describe the incident, how it occurred and what should be done to prevent recurrence:
Casualty Risk Control Manual
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Appendix 3-B
Vehicle Accident Investigation Report Form
Name: / Department:Job Title: / ID Number/SSAN
M / F / Age: / Date of Hire: / Home Phone No.:
Address:
Extent of Injuries:
Describe Property Damage:
Treatment Facility: / Treating Doctor:
RTW Status:
Where is the damaged property now?
Time of Incident: / Time Supervisor Notified:
What Happened?
How did it happen?
What was the employee doing just prior to the incident?
What management controls were deficient?
Equipment: / Selection / Arrangement / Use / Maintenance
Materials: / Selection / Placement/Storage / Handling / Use
People: / Selection / Placement / Training / Leading
What specific measures should be taken?
How will this improve operations?
What have you already done?
Vehicle Involved: / License No.: / Unit No.:
Driver: / Student / Faculty / Staff / Other
Passenger(s):
Purpose of Trip:
Destination: / Departure Time:
Road Conditions:
Weather Conditions:
Traffic Conditions:
Other People Involved:
Extent of Injuries:
Other Vehicle(s)/Property Involved:
Extent of Damage:
Investigated by: / Date:
Reviewed by: / Date:
Add any additional details necessary to describe the incident, how it occurred and what should be done to prevent recurrence:
Appendix 3-C
EIIA Sample Property and Casualty Claims Reporting Information
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Appendix 3-D
EIIA Cause Codes—Workers Compensation
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Miscellaneous1 / Mental Anguish/Stress
3 / Elevator, escalator, dumb waiter
4 / Horseplay
6 / Alcohol, Drugs
Slips and Falls
9 / Stage/Platform/Dock
10 / Ladder/Scaffolding/High Lift/Step Stool
11 / Furniture
12 / Inside—Stairs/Ramps
13 / Washroom/Restroom
14 / Inside—Liquid, Grease, Food
15 / Walk in Cooler/Freezer
16 / Tripped over object
17 / Inside—Different Level
18 / Inside—Same level
21 / Outside—Stairs/Ramps—Weather
22 / Outside—Stairs/Ramps—Not Weather
23 / Outside—Paved Surface—Weather
24 / Outside—Paved Surface—Not Weather
25 / Outside—Unpaved Surface
26 / Outside—Not on Ground
Chemical/Illness/Heat or Cold
27 / Cleaning Chemicals
28 / Lab Chemicals
29 / Pesticides, Insecticides
30 / Paint
31 / Other Chemicals
32 / Air Temperature Extreme
34 / Food Poisoning
35 / Airborne Particles in General Air
36 / Lightning
38 / Contact w/Animal/Insect
39 / Bodily Fluids/Needle
40 / Contact w/Plants
Sport Event/Performing Arts
43 / Playing Sports/Performing Arts
44 / Instructing Sports/Arts
45 / Watching Sports/Arts
Inattention
50 / Window Accident
51 / Door Accident
52 / Drawer Accident
53 / Struck by Item Falling from Shelf, Counter
54 / Step on/Kick Object
55 / Striking a Fixed object
56 / Collision with Another Person
Using Equipment
58 / Trimming Trees, Shrubs
59 / Working with Electrical Systems
60 / Working on a Boiler
61 / Working Overhead
62 / Maintaining/Installing an Object
63 / Using Office Equipment
64 / Using a Knife
65 / Using a Riding Mower
66 / Using a Power Lawn Mower, Weedeater
67 / Welding
68 / Using a Manual Hand Tool/Utensil
69 / Using Powered Hand Tool, Appliance
70 / Using Cleaning Equipment
Manual Material Handling
72 / Lifting, Carrying a Ladder
73 / Loading/Unloading a Vehicle
74 / Hitching a Trailer
75 / Moving Furniture/Mattress
76 / Removing Trash
77 / Handling Hot Object
78 / Injured by Part of Object being Moved
79 / Other Employee at Fault
80 / Slip, Trip, Fall while Carrying
81 / Lifting, Carrying, Pushing, Pulling, Reaching
82 / Throwing, Tossing, Passing
83 / Shoveling, Digging
84 / Using a Cart
Security
88 / Assault/Robbery of Employee
89 / Enforcing Security
Noise
90 / Noise
Transportation
93 / Golf Cart/Unlicensed Vehicle
94 / Bicycle
95 / Entering/Exiting Vehicle
96 / Vehicle Accident
Coding
98 / Liberty Mutual—Not translated
99 / Liberty Mutual—Not coded
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Appendix 3-E
EIIA Cause of Loss Codes—Automobile Liability
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Impaired Insured Vehicle (IV) Driver1 / Unauthorized Use
2 / Accident involved Alleged use of Drugs/Alcohol
3 / Vehicle Accidentally Set in Motion
Insured Vehicle (IV) Driver Error—Parking
10 / Unsafe Parking
11 / Unsafe Backing
12 / Unsafe Starting
Insured Vehicle (IV) Driver Error—On Road
13 / Unsafe Turning
14 / Unsafe U-Turn
15 / Unsafe Passing
16 / Driving in Wrong Lane
17 / Misjudging Clearance (height)
18 / Driving off the Road
19 / Loss of Control—not Ice
20 / Unsafe Ramp Merging
21 / Assuming Right of Way
22 / Disregard of Traffic Sign/Signals
23 / Failure to signal Intentions
24 / Unsafe Following Distance
25 / Unsafe Lane Change
26 / Diverted Attention
27 / Unsafe Condition of Vehicle
28 / Overloading
29 / Unsafe Speed—for Ice/Rain/Snow
30 / Unsafe Speed—for Road Type/Gravel, etc.
31 / Unsafe Speed—Clear Weather
34 / Snow Plow
35 / Tire Blowout
36 / Struck by Train—Not Stalled
Other Vehicle Error
48 / Insured Vehicle Hit While Parked
49 / Insured Vehicle Hit On Road Not In Rear
50 / Insured Vehicle Hit in Rear On Road
Struck By
53 / Struck by Road Debris
55 / Struck by Falling Objects—All Other
Vandalism, Theft
57 / Vandalism
58 / Theft—Vehicle Unlocked/Key not in Ignition
59 / Theft—Vehicle Unlocked/Key in Ignition
60 / Theft—Vehicle Locked
Environment
54 / Struck by Falling Tree Limb
61 / Wind, Hail, Water
62 / Fire, Explosion, Electrical
63 / Riot, Civil Commotion
64 / Acid Spill
65 / Animal/Bird
66 / Solar Heat
Trailer
76 / Drop trailer, jackknife
Coverages
83 / Third party vendor Employee, Volunteer
Entering/Exiting Vehicle
95 / Entering/Exiting Vehicle
Unknown Cause of Damage
96 / Unknown Cause of Damage
Coding
98 / Liberty Mutual—Not translated
99 / Liberty Mutual—Not coded
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Appendix 3-F
EIIA Cause Codes—General Liability
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Miscellaneous Codes1 / Unauthorized Use
2 / Pollution
3 / Day care (not sexual misconduct)
4 / Elevator, escalator, dumb waiter
5 / Fatality
Falls/Slips
7 / Bleachers
8 / Banister, Fence, Railing
9 / Stage, Podium
10 / Ladder, Scaffolding, High Lift
11 / Furniture
12 / Inside – Steps, Stairs, Ramps – all
13 / Inside – Restroom/Washroom – all
14 / Inside – Liquid, grease, etc. on surface
16 / Inside – Tripped over object
17 / Inside – Different level
18 / Inside – Same level
21 / Outside – Steps, Stairs, Ramps, Weather Related
22 / Outside – Steps, Stairs – Not Weather Related
23 / Outside – Paved Surfaces – Weather Related
24 / Outside – Paved Surfaces – Not Weather Related
25 / Outside – Unpaved Surfaces
26 / Jumping, leaping, bounding
Improper Activity
27 / Alleged ADA violation
28 / Failure to Warn/Secure
29 / Alleged Hazing
30 / Quarreling, arguing, fighting, assault
31 / Horseplay
32 / Incident involving alleged use of alcohol, drugs
33 / Robbery
34 / Wrongful entry, theft
35 / Corporal punishment
36 / Unreasonable Force, False Arrest
37 / Alleged age discrimination
38 / Alleged improper security provided
39 / Alleged wrongful, unjust employee termination
40 / Alleged libel, slander, defamation
41 / Alleged sexual harassment
42 / Alleged sexual misconduct
43 / Alleged sexual assault / rape
44 / Alleged sexual discrimination
45 / Alleged race discrimination
46 / Alleged medical malpractice – Institution’s Health Services, Athletic Trainer
47 / Professional Health Care – Student Practicum
48 / Professional Liability – Counseling
49 / Professional Liability – Alleged failure to educate
Struck by / Injured By / Collision With / Contact
50 / Window
51 / Door – not in restroom
52 / Glass – not a window
53 / Restroom/Washroom Facilities including Doors
54 / Furniture
55 / Using equipment – for personal benefit
56 / Using equipment – for institution benefit
57 / Mobile equip, Golf Car, Cushman, Bike, Snowplow
58 / Entering/exiting a motor vehicle
59 / Struck or Injured by object carried by others
60 / Injured by/against fixed object
61 / Struck by injured by falling/flying object
62 / Struck by or collision with another person
63 / Contact with electricity
64 / Struck by security gate
65 / Falling tree branch, ice, snow
66 / Mowing/edging debris
67 / Dumpster
Exposure to / Burn
75 / Fire / explosion
76 / Chemical exposure
77 / Hot liquid (including hot water and steam)
78 / Hot object
79 / Poor ventilation/Sick building syndrome
80 / Water
81 / Paint
Coverages
82 / Field Trip participant
83 / Third party/Vendor Employee, Volunteer
84 / Other Contractual liability
85 / Employee Benefits liability
86 / Pesticide Application
87 / Watercraft / Snowmobile
Noise
90 / Noise
Sport Event /Performing Arts
93 / Struck by ball, hammer, or other athletic equipment
94 / Swimming Accident
95 / Injured with playing sports
96 / Weight room / exercise equipment
Coding
98 / Liberty Mutual – Not translated
99 / Liberty Mutual – Not coded